[Influence of nonsteroidal antiinflammatory drugs in gastrointestinal bleeding due to gastroduodenal ulcers or erosions in patients with liver cirrhosis].

INTRODUCTION Peptic ulcer disease, with or without complications, is more common in patients with liver cirrhosis than in the general population. Factors associated with portal hypertension are involved in its pathogenesis. The prevalence of Helicobacter pylori infection in patients with liver cirrhosis and the general population is similar. The aim of the present study was to determine the influence of nonsteroidal antiinflammatory drugs (NSAIDs) in the etiology of bleeding peptic ulcer disease in patients with liver cirrhosis. PATIENTS AND METHODS We studied 35 patients with liver cirrhosis and gastrointestinal bleeding due to gastroduodenal ulcers or erosions (group A), 125 noncirrhotic patients with gastrointestinal bleeding due to gastroduodenal ulcers or erosions (group B), and 70 patients with liver cirrhosis who were admitted to hospital without gastrointestinal bleeding (group C). All patients were questioned about NSAID consumption, including aspirin, during the week prior to hospital admission. RESULTS NSAID consumption was reported by 15 patients (42.8%) in group A, 102 patients (58.2%) in group B, and 6 patients (8.5%) in group C. Statistically significant differences were obtained when the results for group A were compared with those for group C. CONCLUSIONS NSAID consumption in patients with liver cirrhosis without gastrointestinal bleeding was low (8.5%) and was much lower than that observed in patients with cirrhosis admitted to hospital for bleeding due to gastroduodenal ulcers or erosions (42.8%). As occurs in the general population, NSAIDs play a significant role in the pathogenesis of bleeding due to peptic ulcer disease in patients with liver cirrhosis and portal hypertension.

[1]  D. Tai,et al.  Role ofHelicobacter pylori in cirrhotic patients with peptic ulcer , 1994, Digestive Diseases and Sciences.

[2]  G. Realdi,et al.  Active peptic ulcer disease in patients with hepatitis C virus-related cirrhosis: the role of Helicobacter pylori infection and portal hypertensive gastropathy. , 2004, Canadian journal of gastroenterology = Journal canadien de gastroenterologie.

[3]  J. Gisbert,et al.  The Prevalence of Peptic Ulcer not Related to Helicobacter pylori or Non‐Steroidal Anti‐Inflammatory Drug Use is Negligible in Southern Europe , 2004, Helicobacter.

[4]  F. Roudot-thoraval,et al.  Gastroduodenal Ulcer and Erosions Are Related to Portal Hypertensive Gastropathy and Recent Alcohol Intake in Cirrhotic Patients , 2003, Digestive Diseases and Sciences.

[5]  Chung-Jyi Tsai.  Helicobacter pylori Infection and Peptic Ulcer Disease in Cirrhosis , 1998, Digestive Diseases and Sciences.

[6]  L. Bolondi,et al.  High Prevalence of Helicobacter pylori in Liver Cirrhosis (Relationship with Clinical and Endoscopic Features and the Risk of Peptic Ulcer) , 1997, Digestive Diseases and Sciences.

[7]  M. Vergara,et al.  Helicobacter pylori is a risk factor for peptic ulcer disease in cirrhotic patients. A meta-analysis , 2002, European journal of gastroenterology & hepatology.

[8]  J. Esplugues,et al.  Gastric mucosal resistance to acute injury in experimental portal hypertension , 2001, British journal of pharmacology.

[9]  A. Nassar,et al.  Low incidence of Helicobacter pylori infection in patients with duodenal ulcer and chronic liver disease. , 2001, Scandinavian journal of gastroenterology.

[10]  S. Kitano,et al.  Does portal hypertension contribute to the pathogenesis of gastric ulcer associated with liver cirrhosis? , 2000, Journal of Gastroenterology.

[11]  Á. Lanas,et al.  Toxicity of NSAIDs in the stomach and duodenum. , 1999, European journal of gastroenterology & hepatology.

[12]  V. de Lédinghen,et al.  Anti-inflammatory drugs and variceal bleeding: a case-control study , 1999, Gut.

[13]  B. Dalmau,et al.  Epidemiology of peptic ulcer disease in cirrhotic patients: role of helicobacter pylori infection , 1998, American Journal of Gastroenterology.

[14]  B. Dalmau,et al.  Seroprevalence and epidemiology of Helicobacter pylori infection in patients with cirrhosis. , 1997, Journal of hepatology.

[15]  Shinn-Jang Hwang,et al.  Prevalence of gastric ulcer in cirrhotic patients and its relation to portal hypertension , 1996, Journal of gastroenterology and hepatology.

[16]  J. Frexinos,et al.  Weakness of mucosal barrier in portal hypertensive gastropathy of alcoholic cirrhosis. Effects of propranolol and enprostil. , 1995, Journal of hepatology.

[17]  Y. Liaw,et al.  Helicobacter pylori in cirrhotic patients with peptic ulcer disease: a prospective, case controlled study. , 1995, Gastrointestinal endoscopy.

[18]  S. D. Lee,et al.  Prevalence of duodenal ulcer in cirrhotic patients and its relation to Helicobacter pylori and portal hypertension. , 1995, Zhonghua yi xue za zhi = Chinese medical journal; Free China ed.

[19]  L. Knodel.  Gastrointestinal toxicity of nonsteroidal antiinflammatory drugs , 1994 .